The heat of summer is currently at its peak in Nepal. When the temperature soars in the season, so do the skincare worries. With oily skin, acne flare-ups and irritations, there is one more issue that adds on to the list—that is, photosensitivity. It is when your skin is exposed to UV radiation that you develop an itchy red rash. Although its severity might be heightened during the summer, people who are prone to photosensitivity should take precautions throughout the year, as UV rays are present in every season.

Dr Tapan Pradhan, co-founder and director of Kayakalpa skin and hair clinic shares the causes of photosensitivity and simple preventive tips. He is also a dermatologist at Aavaran Skin and Hair Clinic.

What is photosensitivity, and what are its most common causes?

In simple terms, photosensitivity can be understood as an abnormal immune system reaction to sunlight or UV rays. Mostly, it forms red rashes, patches, skin discolouration and blisters around your skin. There is not a specific type of reaction and it can vary from person to person. Along with sunlight, tanning beds can also trigger photosensitive reactions.

But medical conditions and certain products can also be attributed to its causes:

• Lupus erythematosus

• Rosacea

• Photoeczemas,

• Porphyria (a rare metabolic disorder)

• Polymorphic light eruption (PMLE) — the most common form

• Xeroderma pigmentosum (a genetic condition)

• Certain antibiotics, diuretics, and antifungals

• Chemotherapy drugs

• Fragrances

• Nutritional deficiencies (B3 vitamin)

How can people tell the difference between photosensitivity and a regular sunburn?

This is a common misconception most people have. Anyone can develop a sunburn after staying outside for too long. But a photosensitivity reaction only happens to some people. It is not that uncommon in Nepal, and I have seen such persistence in long durations with many of my clients too; however, not everyone is prone to it.

Sunburn takes time to become visible, while a photosensitive reaction can develop within minutes to a few hours after sun exposure, depending on the underlying cause, the person's skin sensitivity, and the intensity of UV exposure. It is not as serious a medical concern as photosensitivity.

When you get a sunburn, your skin is heated and it can feel painful. On the other hand, with photosensitive reactions, there might be a sharp pain, similar to ant bites. Blisters can also gradually be spotted. In more severe cases, the reaction can progress to even induce a fever.

What precautions should people take to protect their skin if they are prone to photosensitivity?

When dermatologists recommend active ingredients such as retinol or tretinoin for nighttime use, it is for good reason. Applying them during the day can make the skin more susceptible to UV damage and trigger photosensitive reactions. First precaution, is timely usage of skincare products, rather than assuming that it can be applied whenever possible.

Secondly, opting for mineral sunscreens is a good option for sun protection and should be reapplied from time to time throughout the day. Remember to choose a broad-spectrum sunscreen, as it protects against both UVA and UVB rays. A generous amount of it should be applied to all the areas prone to sun exposure.

Also, as I mentioned earlier, actively searching and testing whether the antibiotics and antifungal medicines we consume have been activating sensitive skin reactions is important.

Other precautions are simple: preventing active sunlight during the peak hours of 10-4 and carrying an umbrella at all times.

What should someone do if they experience a photosensitive reaction right after sun exposure?

After you spot a reaction, I recommend immediately covering the skin part with a damp cloth, not ice, as a sudden temperature change can further irritate the skin.

If you are aware that your skin is more photosensitive, try to include fragrance-free moisturisers in your daily routine; that is helpful. Avoid scratching or rubbing the infected area.

Over time, according to the nature of the condition, steroids might also be prescribed by dermatologists to control the symptoms.

What happens when skin photosensitivity remains untreated?

Thinking that it's a temporary problem, which can fix itself on its own, is a mistake. Actively discarding the issue and not applying any preventive measures can ultimately lead to chronic inflammation, accelerated ageing, hyperpigmentation, post-inflammatory pigmentation and even scarring.

Not only that, but avoiding the sun or going out develops into a psychological fear after some time. This is a recurring problem, and people who are photosensitive might have to stay guarded with their skincare for a long period in their lives; thus, it shouldn’t be taken very lightly. Patients may develop anxiety at the thought of stepping outside, fearing that even a few minutes of sun exposure could trigger another reaction. Over time, this fear can affect their daily routine, limiting social activities, outdoor exercise, and even simple errands.